My first therapist shot hoops with me in her driveway. The second thought I’d be more comfortable talking over hot cocoa and marshmallows in a communal kitchen. One gave me a foam bat and told me to hit a chair. Another used a thick marker on poster paper to draw my family tree and the associated neuroses. So yeah, not to brag, but I’m kind of a connoisseur of counseling.
Over the years, all of these therapists—using everything from the role-playing of Gestalt therapy to the talk-it-out approach of psychoanalysis—have helped me cope when I’ve felt like my thoughts were on spin cycle or that I was powerless to remove an anvil from the top of my head. But nothing has been more effective for me than dialectical behavior therapy (DBT), a skills-based approach that can help not only the depressed and anxious but anyone who needs help regulating their emotions—which, let’s face it, is most of us during a pandemic.
DBT was developed in the late 1980s by psychologist Marsha M. Linehan to treat borderline personality disorder, but the cognitive-behavioral psychotherapy is now used for more common mental health concerns. Local DBT groups meet weekly (typically virtually these days) to learn a new skill, and tackle homework assignments from a workbook in between. The process is organized into “modules,” defined as core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Working through each module takes several weeks.
DBT is not a processing kind of therapy; there’s very little talk about how your day went or how mean your dad is. I have found this refreshing after so many years of scouring my soul for stuff to say. DBT has helped me build a toolkit of skills that can be used any time I feel overwhelmed.
The one skill that has served me best—which I’ve shared with friends as they’ve worried about home-schooling, masks, porous surfaces, and the like—is part of a practice called “TIPP,” which stands for “temperature, intense exercise, paced breathing, and paired muscle relaxation.” The “temperature” part is what really sticks with me.
Here’s how it goes: When you feel anxiety or some other intense emotion coming on, you seek out something cold. Dunk your face in a sink full of frigid water, take an icy shower, grab a bag of frozen corn, or submerge yourself in a cold pool.
When I begin to feel particularly blue, I’ll make a beeline for the freezer and pull out an ice pack, hold it in my hand, and I will notice its calming effect. It’s almost as though my brain can’t process both the feeling of cold and the feeling of depression at the same time.
Why does this work? According to studies, wet and cold cause blood to move from the surface of the body, away from the limbs and into the core in an effort to conserve heat. At work here is something called the mammalian diving reflex, a physiological response to immersion in cold water. The heartbeat and breath slow down. The brain is bathed in fresh blood. Then, the sympathetic nervous system is activated, which increases the release of norepinephrine, an adrenal hormone that can elevate a depressed person’s mood, according to Psychology Today.
So, if you’re looking for a way to cope in these challenging and uncertain times, take it from this psychotherapy swashbuckler—maybe it’s time to put your overwhelming emotions on ice.
This article appears in our November 2020 issue.